Sarcopenic obesity predicts instrumental activities of daily living disability in the elderly

Obes Res. 2004 Dec;12(12):1995-2004. doi: 10.1038/oby.2004.250.


Objective: To determine the association of sarcopenic obesity with the onset of Instrumental Activities of Daily Living (IADL) disability in a cohort of 451 elderly men and women followed for up to 8 years.

Research methods and procedures: Sarcopenic obesity was defined at study baseline as appendicular skeletal muscle mass divided by stature squared <7.26 kg/m2 in men and 5.45 kg/m2 in women and percentage body fat greater than the 60th percentile of the study sample (28% body fat in men and 40% in women). Incident disability was defined as a loss of two or more points from baseline score on the IADL. Subjects with disability at baseline (scores < 8) were excluded. Cox proportional hazards analysis was used to determine the association of baseline sarcopenic obesity with onset of IADL disability, controlling for potential confounders.

Results: Subjects with sarcopenic obesity at baseline were two to three times more likely to report onset of IADL disability during follow-up than lean sarcopenic or nonsarcopenic obese subjects and those with normal body composition. The relative risk for incident disability in sarcopenic obese subjects was 2.63 (95% confidence interval, 1.19 to 5.85), adjusting for age, sex, physical activity level, length of follow-up, and prevalent morbidity.

Discussion: This is the first study, to our knowledge, to indicate that sarcopenic obesity is independently associated with and precedes the onset of IADL disability in the community-dwelling elderly. The etiology of sarcopenic obesity is unknown but may include a combination of decreases in anabolic signals and obesity-associated increases in catabolic signals in old age.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Activities of Daily Living*
  • Adipose Tissue
  • Aged
  • Aging*
  • Arthritis / epidemiology
  • Body Composition
  • Cardiovascular Diseases / epidemiology
  • Diabetes Mellitus, Type 2 / epidemiology
  • Disabled Persons / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Muscle Weakness / complications*
  • Muscular Atrophy / complications*
  • Obesity / complications*
  • Proportional Hazards Models
  • Risk